title: The cost-effectiveness of depression treatment for co-occurring disorders: a clinical trial.
abstract: The authors aimed to determine the economic value of providing on-site group cognitive behavioral therapy (CBT) for depression to clients receiving residential substance use disorder (SUD) treatment. Using a quasi-experimental design and an intention-to-treat analysis, the incremental cost-effectiveness and cost-utility ratio of the intervention were estimated relative to usual care residential treatment. The average cost of a treatment episode was $908, compared to $180 for usual care. The incremental cost effectiveness ratio was $131 for each point improvement of the BDI-II and $49 for each additional depression-free day. The incremental cost-utility ratio ranged from $9,249 to $17,834 for each additional quality adjusted life year. Although the intervention costs substantially more than usual care, the cost effectiveness and cost-utility ratios compare favorably to other depression interventions. Health care reform should promote dissemination of group CBT to individuals with depression in residential SUD treatment.
authors.affiliation: RAND Corporation, Santa Monica, CA 90401, USA. Electronic address: kwatkins@rand.org.
authors.forename: Katherine E
authors.initials: KE
authors.lastname: Watkins
authors.forename: Alison E
authors.initials: AE
authors.lastname: Cuellar
authors.forename: Kimberly A
authors.initials: KA
authors.lastname: Hepner
authors.forename: Sarah B
authors.initials: SB
authors.lastname: Hunter
authors.forename: Susan M
authors.initials: SM
authors.lastname: Paddock
authors.forename: Brett A
authors.initials: BA
authors.lastname: Ewing
authors.forename: Erin
authors.initials: E
authors.lastname: de la Cruz
mesh_terms: D015928:Cognitive Behavioral Therapy / Q000191:economics / Q000379:methods*; D003362:Cost-Benefit Analysis; D003866:Depressive Disorder / Q000150:complications / Q000191:economics / Q000628:therapy*; D017831:Diagnosis, Dual (Psychiatry); D017048:Health Care Costs; D006801:Humans; D011615:Psychotherapy, Group / Q000191:economics / Q000379:methods*; D019057:Quality-Adjusted Life Years; D012114:Residential Treatment / Q000191:economics / Q000379:methods; D016320:Substance Abuse Treatment Centers / Q000191:economics; D019966:Substance-Related Disorders / Q000150:complications / Q000191:economics / Q000534:rehabilitation*; D016896:Treatment Outcome
keywords: Cognitive–Behavioral therapy; Cost-effectiveness; Depression